Community and Global Neurology

“Through WHO’s global dementia priority setting exercise, we hope that the research priorities identified by this intensive and systematic international process will inform and motivate policymakers, funders and researchers to reduce the global burden of dementia.”

“Here in Washington Heights, we serve one of the most ethnically diverse communities in the world. I am dedicated to improving neurological care for the most socioeconomically vulnerable populations, both in New York City and abroad.”

“Everyone wants to know why we're teaching children about stroke. We always tell them that children can save lives, and as a result of our program, they have! The Hip Hop Stroke Program was born out of a realization that our black community is disproportionately affected by stroke. I wanted to change that.”

"WHO estimates indicate that death from stroke in low-income and middle-income countries accounted for 85·5% of stroke deaths worldwide. Lack of neurologists specialized in acute stroke care in low-income countries warrants systematic training of emergency medicine or primary care doctors of acute management of neurological emergencies. With the help of validated online curriculum supplemented by simulation of real life scenarios, I believe we could achieve our goal of saving such lives."

“In the earliest days of the AIDS/HIV pandemic, New York City was epicentre, and I have worked over the last twenty five years to develop and manage multidisciplinary medical care and treatment programs for HIV infected children and to implement programs for prevention of mother to child transmission of HIV. The success of these efforts can be measured by the virtual elimination of new cases of perinatally acquired HIV, In addition, for those who acquired HIV perinatally prior to availability of effective prevention, what had once been a uniformly fatal illness is now a chronic disease. Where survival had once been measured in months or years, good health and life expectancy are now considered in decades (and still counting!).”

“At a young age, I was exposed to a wide variety of socioeconomic and cultural environments - both internationally (in the Caribbean) and locally in New York City. These experiences made me acutely aware of social disparities and spurred a lifelong commitment to mitigating the negative impacts of these disparities. Most recently, my efforts to this end has included partnership with Epilepsy Foundation of Metropolitan New York, mentoring local college students with the CUIMC Office of Diversity and Multicultural Affairs, and working with American Academy of Neurology on their efforts to improve the neurological care of ethnically and socioeconomically diverse communities.”

“There is strong evidence that small vessel cerebrovascular disease contributes to poorer cognition in later life.  We have been interested in understanding the extent to which small cerebrovascular changes are involved with Alzheimer’s disease specifically.  Our work focuses on the racially and ethnically diverse community around the medical center and on cohorts in Venezuela and the Dominican Republic.”

“As past president of the National Medical Association, and a practicing neurologist for over 30 years at Columbia University Irving Medical Center, I am a strong advocate for healthcare for all Americans, including our most vulnerable underserved minority populations. I have fought for these rights and will continue to fight until all Americans have access to the care they deserve.”

“Working in Malawi - an environment with limited resources - was incredibly challenging and rewarding. I saw the neurological manifestations of parasitic infections including malaria, cystercercosis and schistosomiasis as well as tuberculosis and end stage AIDS, none of which I had much exposure to prior to this experience.  I was able to hone my diagnostic skills as imaging and other tests are limited or unavailable. It was incredibly humbling to care for patients in the clinics who had heard there was a neurologist visiting and had traveled for hours, sometimes on foot, to see us.”

“HIV infected patients are at high risk of stroke, and I am working to understand how vascular risk factors affect brain arteries and predispose individuals to have stroke and other cerebrovascular outcomes. I spend much of my time investigating stroke risks among underserved populations and educating communities about ways to control some of these risk factors.”

“With colleagues in South Africa, I study how best to identify and treat a particularly vulnerable population--HIV-infected infants and young children. I address major challenges of resistance to antiretroviral drugs and how to optimize treatment initiation in infancy.”

“As a native Dominican, I have spent my medical career dedicated to promoting the health of our local, diverse population in Northern Manhattan and the health of individuals in the Dominican Republic. We are studying the impact of aging both locally and in the Dominican Republic, and hoping to improve our understanding of risk factors, and improve access to care for this growing aging population.”

“The mechanisms of disparities in cognitive aging and dementia are unknown. As the number of people at risk for dementia are unknown. As the number of people at risk for dementia increases, it is imperative that we identify causes of disparities across racial and socioeconomic groups in order to reduce the societal burden of cognitive impairment. My prior work in the community of Washington Heights and my involvement in national studies of diverse cohorts of middle aged and older adults, points to the importance of early life social factors as powerful determinants of later life cognitive function. My current research aims to determine the social, biological, and genetic pathways through with race and education influence cognitive impairment and dementia, in order to identify opportunities for prevention and intervention.”

“Caring for families with Parkinson's disease and Huntington's disease from the Washington Heights Inwood community, and providing them with the opportunity to participate in clinical trials and observational research has been a tremendous learning experience for me. Visiting people in their homes, and learning about all the social and environmental factors, in addition to genetic predisposition that shape a person's ability to live with a disease is compelling. Studying these diseases in multiple ethnic groups is far more powerful and generalizable than traditional, clinic based models and is what makes the CUIMC community so special.”

“Since 1989, here in northern Manhattan, members of our department have conducted a multidisciplinary, population-based investigation of Alzheimer's disease and related disorders among three ethnic groups (Caucasian, Hispanic, African American), known as the Washington Heights-Inwood Community Aging Project (WHICAP). Through the study of this and other, similar cohorts based both nationally and internationally, we aim to integrate genetic risk factors and epidemiological principles in an attempt to identify biological markers of susceptibility to degenerative diseases of the aging nervous system. The ultimate goal from all this is to develop a therapeutic intervention.”

“I have spent my career working to better understand underlying causes of health disparities related to neurological disorders of aging, focusing on health literacy, modifiable risk factors, and community outreach and care programs in Alzheimer's disease. I co-founded a museum-based, art-centered program for dementia patients and their caregivers (Arts & Minds) and created a hip hop-themed Alzheimer's disease education strategy (Old SCHOOL Hip Hop). Both of these programs have been delivered in disadvantaged communities and continue to expand through community partnerships and research programs.”

“It is critical that our trainees understand their local community and environment while caring for patients; it is one of my primary goals to educate the next generation of neurologists so that they are able to communicate with their patients effectively and help them navigate our complex healthcare system–we know this impacts health outcomes.”